Oral Plan associated with psychogenic factors: Case report
DOI:
https://doi.org/10.33448/rsd-v10i3.13178Keywords:
Oral Lichen Planus; Oral Leukoplakia; Psychological Distress; Oral manifestations.Abstract
Oral lichen planus is a chronic mucocutaneous disease responsible for destroying the basal layer of the epithelium and, when not controlled, predisposing to malignancy. Despite its uncertain etiology, stress and anxiety have often been highlighted as promoting factors for this pathology. Thus, this study aims to report a case of a male patient with oral lichen planus (OLP) associated with psychogenic factors. Male patient, leucoderma, 32 years old, sought dental care with the main complaint that he had a white spot on his tongue, which burned when eating, and lasted for one year. During the anamnesis, the patient reported not having harmful habits or using controlled medications, however, he had a history of stress and anxiety due to the recent change in the dynamics of his personal life. On intraoral physical examination, white lesions were observed in the lateral region of the tongue and in the region of the right retromolar triangle. The clinical hypotheses of leukoplakia and lichen planus were suggested and an incisional biopsy was performed, and the surgical specimen was sent for histopathological analysis. Microscopic findings showed hyperkeratosis, acanthosis, Civatte bodies and a chronic inflammatory infiltrate containing lymphocytes, macrophages and plasma cells, leading to the final diagnosis of OLP. In addition, the patient was instructed to seek professional psychological support. The patient was followed up for a period of 2 months and, during his return, tissue recovery was observed, without symptoms or recurrence. Therefore, psychogenic factors, such as stress and anxiety, can have a negative influence on the exacerbation and appearance of oral lichen planus.
References
Aguiar, C., Castro, T., Carvalho, A., Vale, O., Sousa, F., & Vasconcelos, S. (2011). Antidepressantdrug. Acta Médica Portuguesa, 24 (1), 91-98. Recuperado de https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/339/109%3e. doi: http://dx.doi.org/10.20344/amp.339
Andreatini, R., Boerngen-Lacerda, R., & Zorzetto, F. D. (2001).Tratamento farmacológico do transtorno de ansiedade generalizada: perspectivas futuras. Revista Brasileira de Psiquiatria, 23 (4), 233-242. Recuperado de https://www.scielo.br/scielo.php?pid=S1516-44462001000400011&script=sci_abstract&tlng=pt.doi:10.1590/S1516-44462001000400011
Biaggio, A. M . B. & Natalílio, L. (1979). Manual para o inventário de ansiedade traço-estado (IDATE). Rio de Janeiro:Centro de Psicologia Aplicada-CEPA
Boorghani, M., Gholizadeh, N., TaghaviZenouz, A., Vatankhah, M., & Mehdipour, M. (2010). Oral lichen planus: clinical features, etiology, treatment and management; a review of literature. Journal of dental research, dental clinics, dental prospects, 4(1), 3–9.Recuperado de https://pubmed.ncbi.nlm.nih.gov/22991586/.doi: 10.5681 / joddd.2010.002
Chan, E. S. Y., Thornhill M., & Zakrzewska J. JM. (1999). Interventions for treating oral lichen planus.Cochrane Database of Systematic Reviews, 2.Recuperado de https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001168/full doi: 10.1002/14651858.CD001168.
Charazinska-Carewicz, K., Ganowicz, E., Krol, M., & Gorska, R. (2008).Assessment of the peripheral immunocompetent cells in patients with reticular and atrophic-erosive lichen planus.Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, 105(2), 202–205.Recuperado de https://pubmed.ncbi.nlm.nih.gov/17656134/.doi:10.1016/j.tripleo.2007.03.031
Chaudhary, S. (2004).Psychosocial stressors in oral lichen planus.Australian dental journal, 49(4), 192–195. Recuperado de https://pubmed.ncbi.nlm.nih.gov/15762340/. doi:10.1111/j.1834-7819.2004.tb00072.x
Chiappelli, F., Kung, M. A., Nguyen, P., Villanueva, P., Farhadian, E. A., & Eversole, L. R. (1997). Cellular immune correlates of clinical severity in oral lichen planus: preliminary association with mood states. Oral diseases, 3(2), 64–70. Recuperado de https://pubmed.ncbi.nlm.nih.gov/9467344/.doi:10.1111/j.1601-0825.1997.tb00014.x
Eisen, D., Carrozzo, M., Bagan S., J. V., & Thongprasom, K. (2005), Número V Líquen plano oral: características clínicas e gestão. Oral Diseases, 11, 338-349. Recuperado de https://onlinelibrary.wiley.com/action/showCitFormats?doi=10.1111%2Fj.1601-0825.2005.01142.x. doi:10.1111/j.1601-0825.2005.01142.x
Eisenberg, E. (2000). Oral lichen planus: a benign lesion. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 58(11), 1278–1285. Recuperado de https://pubmed.ncbi.nlm.nih.gov/11078140/. doi:10.1053/joms.2000.16629
Fitzpatrick, S. G., Hirsch, S. A., & Gordon, S. C. (2014). The malignant transformation of oral lichen planus and oral lichenoid lesions: a systematic review. Journalofthe American Dental Association (1939), 145(1), 45–56. Recuperado de https://pubmed.ncbi.nlm.nih.gov/24379329/. doi:10.14219/jada.2013.10
Hampf, B. G., Malmström, M. J., Aalberg, V. A., Hannula, J. A., & Vikkula, J. (1987). Psychiatric disturbance in patients with oral lichen planus.Oral surgery, oral medicine, and oral pathology, 63(4), 429–432.Recuperado de https://pubmed.ncbi.nlm.nih.gov/3472142/. doi:10.1016/0030-4220(87)90254-4
Hirota, S. K. (2007). Líquen plano: etiopatogenia (Tese de Doutorado). Universidade de São Paulo-USP, São Paulo, SP, Brasil. Recuperado de https://www.teses.usp.br/teses/disponiveis/23/23139/tde-11042008-124535/publico/SilvioKenjiHirota.pdf
Huber M. A. (2004).Oral lichen planus.Quintessence international (Berlin, Germany: 1985), 35(9), 731–752.Recuperado de https://pubmed.ncbi.nlm.nih.gov/15470998/
Kurago, Z. B. (2016). Etiology and pathogenesis of oral lichen planus: an overview. Oral surgery, oral medicine, oral pathology and oral radiology, 122(1), 72–80.Recuperado de https://pubmed.ncbi.nlm.nih.gov/27260276/.doi: 10.1016 / j.oooo.2016.03.011
Lundqvist, E. N., Wahlin, Y. B., Bergdahl, M., &Bergdahl, J. (2006). Psychological health in patients with genital and oral erosive lichen planus.Journal of the European Academy of Dermatology and Venereology: JEADV, 20(6), 661–666. Recuperado de https://pubmed.ncbi.nlm.nih.gov/16836492/. doi:10.1111/j.1468-3083.2006.01559.x
Medwar, C. V., & Matheus, M. E. (2012). Antidepressivos Tricíclicos e Gabapentinóides: uma análise do perfil farmacológico no tratamento da dor neuropática. Revista Brasileira de Fármacia, 93, 290-297. Recuperado de https://www.scielo.br/scielo.php?script=sci_nlinks&pid=S1981-8637201600040044700013&lng=en
Mezzari, R., Iser, B. P. M. (2015). Desafios na prescrição de benzodiazepínicos em unidades básicas de saúde. Revista da Associação Médica do Rio Grande do Sul, 59(3), 198-203. Recuperado de http://www.amrigs.org.br/revista/59-03/07_1507_Revista%20AMRIGS.pdf.
Navas-Alfaro, S. E., Fonseca, E. C., Guzmán-Silva, M. A., &Rochael, M. C. (2003). Análise histopatológica comparativa entre líquen plano oral e cutâneo. Jornal Brasileiro de Patologia e Medicina Laboratorial, 39(4), 351-360. Recuperado de https://www.scielo.br/scielo.php?script=sci_arttext&pid=S1676-24442003000400013. doi:10.1590/S1676-24442003000400013
Pereira A.S. et al. (2018). Metodologia da pesquisa científica. [e-book]. Santa Maria. Ed. UAB/NTE/UFSM. Disponível em: https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1
Pokupec, J. S., Gruden, V., &Gruden, V., Jr (2009). Lichen ruberplanus as a psychiatric problem. PsychiatriaDanubina, 21(4), 514–516. Recuperado de https://pubmed.ncbi.nlm.nih.gov/19935485/
Riga-Neto, A. A., Andrade, C. R., Navarro, C. M., Onofre, M. A., &Massucato, E. M. S. (2013). Líquen plano e relação liquenóide: uma discussão diagnóstica. Revista de Odontologia da UNESP, 42, 1807-2577. Recuperado de https://www.revodontolunesp.com.br/article/5880197b7f8c9d0a098b518c.
Robledo-Sierra, J.,& van der Waal, I. (2018). How general dentists could manage a patient with oral lichen planus. Medicina oral, patologia oral y cirugia bucal, 23(2), e198–e202. Recuperado de https://pubmed.ncbi.nlm.nih.gov/29476684/.
Schenkel, J. S., Lübbers, H. T., Rostetter, C., & Metzler, P. (2017).Traitementmédicamenteux du lichen plan buccal.Swiss dental journal, 127(6), 538–539.Recuperado de https://pubmed.ncbi.nlm.nih.gov/28639683/.
Silva, A. B. B. (2011) Mentes ansiosas: medo e ansiedade além dos limites. Rio de Janeiro: Objetiva.
Silverman, S., Jr, Gorsky, M., & Lozada-Nur, F. (1985). A prospective follow-up study of 570 patients with oral lichen planus: persistence, remission, and malignant association. Oral surgery, oral medicine, and oral pathology, 60(1), 30–34. Recuperado de https://pubmed.ncbi.nlm.nih.gov/3862010/. doi:10.1016/0030-4220(85)90210-5
Souza, F. A. C. G., & Rosa, L. E. B. (2005). Perfil epidemiológico dos casos de líquen plano oral pertencentes aos arquivos da disciplina de patologia bucal da Faculdade de Odontologia de São José dos Campos – UNESP. Ciência Odontológica Brasileira, 8(4), 96-100. Recuperado de https://ojs.ict.unesp.br/index.php/cob/article/view/404. doi:10.14295/bds.2005.v8i4.404
Sugerman, P. B., Savage, N. W., Walsh, L. G., Zhao, Z. Z., Zhou, X. J., Khan, A. et al. (2002). The pathogenesis of oral lichen planus. Crit Ver Oral Biol, 13(4), 350-65.
Vallejo, M. J.,Huerta, G., Cerero, R., & Seoane, J. M. (2001). Anxiety and depression as risk factors for oral lichen planus.Dermatology (Basel, Switzerland), 203(4), 303–307. Recuperado de https://pubmed.ncbi.nlm.nih.gov/11752817/. doi:10.1159/000051777
Van der Meij, E. H., & van der Waal, I. (2003).Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications.Journal of oral pathology &medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 32(9), 507–512. Recuperado de https://pubmed.ncbi.nlm.nih.gov/12969224/.doi:10.1034/j.1600-0714.2003.00125.x
Vilanova, L. S. R., Danielli, J. Pedroso, L., & Silva, M. A. G. S. (2012). Perfil epidemiológico de portadores de líquen plano oral atendidos no centro Goiano de doenças da boca (CGDB) - 12 anos de experiência. Revista Odontologica do Brasil Central, 21(59), 526-529. Recuperado de https://www.robrac.org.br/seer/index.php/ROBRAC/article/view/680/656
Volkweis, M. R., Blois, M. C., & Zanin, R. F. (2015). Estudo retrospectivo de líquen plano bucal em um centro de especialidades odontológicas. Revista de Cirurgia e Traumatologia Buco-Maxilo-Facial, 15(2), 15-20. Recuperado de https://www.revistacirurgiabmf.com/2015/2/02-EstudoretrospectivodeLiquen.pdf
Tomaz, A. J., Willian, P. J., Quinto, J. H. S., Veltrini, V. C., Iwaki, L. C. V., & Tolentino, E. S. (2015). Potencial de Transformación Maligna delLiquen Plano Oral: Estudio Retrospectivo. Internationaljournalofodontostomatology, 9(3), 511-517. Recuperado de https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0718-381X2015000300025 doi:10.4067/S0718-381X2015000300025
Thornhill, M. H., Sankar, V., Xu, X. J., Barrett, A. W., High, A. S., Odell, E. W., Speight, P. M., & Farthing, P. M. (2006). The role of histopathological characteristics in distinguishing amalgam-associated oral lichenoid reactions and oral lichen planus.Journal of oral pathology & medicine: official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 35(4), 233–240. Recuperado de https://pubmed.ncbi.nlm.nih.gov/16519771/. doi:10.1111/j.1600-0714.2006.00406.x
Werneck, J. T., Miranda, F. B., & Silva, J. A. (2016). A. Desafios na distinção de lesões de Líquen Plano Oral e Reação Liquenóide. Revista Brasileira de Odontologia, 73(3), 247-52. Recuperado de http://www.revista.aborj.org.br/index.php/rbo/article/view/770. doi: 10.18363/rbo.v73n3.p.247
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Isabella Fernanda de Melo Vasco; Sybelle Souza Oliveira Malta; Carlos Vinícius Ramos Leão de Oliveira; Kelly Rodrigues Mota; Islane Caroline Ferreira da Silva; Luiz Carlos Oliveira dos Santos
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
